Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Jul 30;16(7):e0255327.
doi: 10.1371/journal.pone.0255327. eCollection 2021.

Patient delay and associated factors among tuberculosis patients in Gamo zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study

Asrat Arja  1 , Wanzahun Godana  2 , Hadiya Hassen  2 , Biruk Bogale  3
Affiliations
Randomized Controlled Trial

Patient delay and associated factors among tuberculosis patients in Gamo zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study

Asrat Arja et al. PLoS One. .

Abstract

Background: Delayed tuberculosis diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control. Therefore, the main objective of this study was to assess the magnitude and factors associated with patient delay among tuberculosis patients in Gamo Zone, Southern Ethiopia.

Methods: A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities of the study area were selected randomly and 255 TB patients who were ≥18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Patient delay was analyzed using the median as the cut-off value. Multivariable logistic regression analysis was fitted to identify factors associated with patient delay. A p-value of ≤ 0.05 with 95% CI was considered to declare a statistically significant association.

Results: The median (inter-quartile range) of the patient delay was 30 (15-60) days. About 56.9% of patients had prolonged patients' delay. Patient whose first contact were informal provider (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI] 1.29, 3.86), presenting with weight loss (AOR: 2.53; 95%CI: 1.35, 4.74) and fatigue (AOR: 2.38; 95%CI: 1.36, 4.17) and body mass index (BMI) categories of underweight (AOR: 1.74; 95%CI: 1.01, 3.00) were independently associated with increased odds of patient delay. However, having good knowledge about TB (AOR: 0.44; 95% CI: 0.26, 0.76) significantly reduce patients' delay.

Conclusion: In this study, a significant proportion of patients experienced more than the acceptable level for the patient delay. Knowledge about TB, the first action to illness, presenting symptoms, and BMI status were identified factors associated with patient delay. Hence, raising public awareness, regular training, and re-training of private and public healthcare providers, involving informal providers, and maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long delays in the management of TB.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Perceived reasons for delay health care seeking among TB patients in Gamo zone public health facilities, Southern Ethiopia, 2019.
Fig 2
Fig 2. Complaints, which made patients, seek medical care in Gamo zone public health facilities, Southern Ethiopia, 2019.
See this image and copyright information in PMC

References

    1. Organization WH. Global tuberculosis control: WHO report 2010: World Health Organization; 2010.
    1. EthiopianFederal Ministry of Health (FMoH). Guidelines for clinical and programmatic management of TB, TB/HIV and Leprosy in Ethiopia. Addis Ababa: Federal Ministry of Health (FMoH); 2016.
    1. Ward H, Marciniuk D, Pahwa P, Hoeppner V. Extent of pulmonary tuberculosis in patients diagnosed by active compared to passive case finding. The International Journal of Tuberculosis and Lung Disease. 2004;8(5):593–7. - PubMed
    1. World Health Organization. The end TB strategy: global strategy and targets for tuberculosis prevention, care and control after 2015 Geneva: WHO; 2015. [Available from: https://www.who.int/tb/post2015_strategy/en/.
    1. Organization WH. TB Aglobal emergency. USA: WHO; 1994.

Publication types